University of Oulu

Prusila, R.E.I., Sorigue, M., Jauhiainen, J., Mercadal, S., Postila, A., Salmi, P., Tanhua, T., Tikkanen, S., Kakko, S., Kuitunen, H., Pollari, M., Nystrand, I., Kuusisto, M.E.L., Vasala, K., Jantunen, E., Korkeila, E., Karihtala, P., Sancho, J.‐M., Turpeenniemi‐Hujanen, T. and Kuittinen, O. (2019), Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era. Br J Haematol, 187: 364-371. doi:10.1111/bjh.16090

Risk of secondary haematological malignancies in patients with follicular lymphoma : an analysis of 1028 patients treated in the rituximab era

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Author: Prusila, Roosa E. I.1; Sorigue, Marc2; Jauhiainen, Jyrki3;
Organizations: 1Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
2Department of Haematology, ICO‐Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Badalona, Spain
3Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
4Department of Haematology, ICO‐Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
5Department of Haematology, Oulu University Hospital, Oulu, Finland
6Department of Oncology, Tampere University Hospital, Tampere, Finland
7Department of Oncology, Turku University Hospital, Turku, Finland
8Siunsote – Hospital District of North Carelia, Joensuu, Finland
9Department of Oncology and Radiotherapy, Central Finland Central Hospital, Jyväskylä, Finland
10Department of Medicine, Kuopio University Hospital, Kuopio, Finland
11Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
12Department of Oncology, Kuopio University Hospital, Kuopio, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2020051435619
Language: English
Published: John Wiley & Sons, 2019
Publish Date: 2020-07-03
Description:

Summary

Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow‐up time of 5·6 years. The 5‐year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5‐year risk of SHM was 0·5% after the first‐line treatment and 1·6% after the second‐line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first‐line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first‐line treatment, thereby postponing the added risk of SHM.

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Series: British journal of haematology
ISSN: 0007-1048
ISSN-E: 1365-2141
ISSN-L: 0007-1048
Volume: 187
Issue: 3
Pages: 364 - 371
DOI: 10.1111/bjh.16090
OADOI: https://oadoi.org/10.1111/bjh.16090
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Subjects:
Funding: This study was funded by the Finnish Haematology Association, the Blood Disease Research Foundation and The Väisänen Fund in TERTTU‐foundation.
Copyright information: © 2019 British Society for Haematology and John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Prusila, R.E.I., Sorigue, M., Jauhiainen, J., Mercadal, S., Postila, A., Salmi, P., Tanhua, T., Tikkanen, S., Kakko, S., Kuitunen, H., Pollari, M., Nystrand, I., Kuusisto, M.E.L., Vasala, K., Jantunen, E., Korkeila, E., Karihtala, P., Sancho, J.‐M., Turpeenniemi‐Hujanen, T. and Kuittinen, O. (2019), Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era. Br J Haematol, 187: 364-371. doi:10.1111/bjh.16090, which has been published in final form at https://doi.org/10.1111/bjh.16090. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.